activity/event request for Childcare services

Please complete the following to schedule an activity or event with the Child Care Facility and Staff. Completion of all fields is required.

Today's Date:
Contact Name:
Name of Department:
Contact Email:
Contact Phone:
Date of Event:
Drop-off Time:
Number of Children:
Pick-up Time:

Please provide a description for utilizing our facilities:

I understand that by submitting this form I will be responsible for scheduling the use of the Child Development Center (CDC) facility. I will assure that the fees for utilizing the CDC facilities will be paid. I understand that completion and submission of this application does not guarantee my request; a representative for the CDC will confirm this request by phone or email.

The CDC will submit a billing form to the contact person along with any timesheets for the staff within two business days following the event. It is the responsibility of the contact person to process the documentation for payment. Payment must be received within 15 days.

The CDC does not provide snacks and/or meals. Arrangements for food service will be the responsibility of the applicant; however, the CDC Staff will serve the food provided.

CDC Rates: Application fee of $25.00 and $10.00 per hour for use of the facility. An additional $10 per hour will be charged for each CDC staff person needed to supervise children.

© Copyright 2003, United Tribes Technical College, all rights reserved.
United Tribes Technical College is a nonprofit corporation owned and operated by the five tribes located wholly or in part in North Dakota. Tribal owners: Three Affiliated Tribes of Ft. Berthold, Spirit Lake Tribe, Standing Rock Sioux Tribe, Sisseton Wahpeton Sioux Tribe, and Turtle Mountain Band of Chippewa.